Gout

What is gout?

Gout is an inflammation of the joints that is caused by a chemical called uric acid. Uric acid is increased in the body by eating some foods (especially seafood, red meat and liver/kidneys), as well as by drinking alcohol. Typical symptoms are severe pain in a joint (often the big toe) accompanied by redness, swelling and difficulty moving the joint. Treatment involves avoiding foods that cause gout and medications to relieve pain and decrease the amount of uric acid in the body. Many people are able to manage and avoid episodes of gout using these measures.

Risks

Gout is caused by excess uric acid in the blood, which forms crystals in the joint. These crystals are very irritating, and cause the joint to become inflamed (red, swollen and painful). Gout is a very common condition. Gout tends to affect more men than women, and becomes more common with age. Drinking alcohol, eating red meat and organ meats (liver/kidneys) and using some medications increase the chances of having gout.

Symptoms

Symptoms are caused by the inflammation of the joint. Typical symptoms are severe pain in a joint (often the big toe), redness, swelling and difficulty moving the joint. Symptoms often come on suddenly, and attacks of gout are often recurrent. The big toe is one of the most commonly affected joints, however, gout can affect any joint.

Diagnosis

Diagnosis is based on a patient's history and physical examination. A doctor might take a sample of the fluid from a swollen joint to identify evidence of gout crystals in the joint. Blood tests can monitor the amount of uric acid in the blood. Ultrasounds or x-rays of the joint may be helpful to look for signs of damage as a result of gout.

Treatment

Pain and swelling during an attack of gout is managed with anti-inflammatory and pain-relieving medications (ibuprofen, paracetamol) or colchicine. Preventing future attacks of gout can be done by changing the diet to avoid foods that trigger attacks of gout and, if needed, with a medication called allopurinol. Allopurinol reduces the amount of uric acid in the blood.

Prevention

Gout may be prevented by avoiding alcohol, as well as by avoiding foods which often trigger gout attacks (red meat, seafood and liver/kidney). Losing weight might also help to prevent future attacks of gout.